점상내측맥락막병증에서 베바시주맙 치료 후 재발된 맥락막 신생혈관의 치료 1예
Management of Relapsed Inflammatory Choroidal Neovascularization in Punctate Inner Choroidopathy after Bevacizumab
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목적: 단안에 발생한 점상내측맥락막병증에 동반된 황반하 맥락막 신생혈관막 치료로 유리체강 내 베바시주맙 주사 치료 시행 후 호전되었다가 재발된 드문 증례를 치료하고 이를 문헌고찰과 함께 보고하고자 한다. 증례요약: 근시를 동반한 25세 여자 환자가 우안에 발생한 점상내측맥락막병증에 동반된 황반하 맥락막 신생혈관막으로 진단 받고 한 달 간격으로 세 번 유리체강 내 베바시주맙 주사 치료 후 호전되었다. 마지막 주사 2개월 후 처음보다 훨씬 심해진 맥락막 염증과 신생혈관막이 재발되어 고용량의 전신 스테로이드와 유리체강 내 베바시주맙 주사를 병합 치료하여 해부학적인 호전과 시력호전을 경험하였다. 결론: 점상내측맥락막병증에 동반된 황반하 맥락막 신생혈관막 치료로 유리체강 내 베바시주맙 주사 치료 후 재발된 염증성 병변에 전신적인 스테로이드와 유리체강 내 주사를 병합하여 치료하고 18개월 이상 재발 없이 안정적인 시력이 유지되었다.
Abstract
Purpose: To report a rare case of relapsed inflammatory choroidal neovascularization (CNV) in a young female patient after intravitreal bevacizumab (IVB) treatment for subfoveal CNV secondary to punctate inner choroidopathy (PIC). Case summary: A 25-year-old myopic female presented with PIC complicated by subfoveal CNV in the right eye. Her lesion initially responded to three monthly 1.25 mg IVB injections, but the lesion recurred two months after the final injection, and the size of the lesion was larger than that observed before treatment. Further treatment with systemic steroids and IVB resulted in successful anatomic and visual improvement. Conclusions: This report presents a rare case of relapsed inflammatory CNV in a young female patient after IVB treatment for subfoveal CNV secondary to PIC. Systemic steroid and IVB were performed after relapse, which successfully improved and maintained vision for longer than 18 months.
참고문헌 (14)
- Watzke RC., "Punctate inner choroidopathy", Am J Ophthalmol, 98, pp.572~584 (1984)
- Brown J Jr., "Visual prognosis of multifocal choroiditis, punctate inner choroidopathy, and the diffuse subretinal fibrosis syndrome", Ophthalmology, 103, pp.1100~1105 (1996)
- Jiménez B., "Intravitreal ranibizumab in the treatment of subretinal neovascularization in a case of punctate inner choroidopathy", Arch Soc Esp Oftalmol, 89, pp.130~132 (2014)
- 조희윤, "점상내층맥락막병증의 임상양상", 대한안과학회지, 45(12), pp.14~14 (2004), 대한안과학회
- Mansour AM., "Long-term visual outcomes of intravitreal bevacizumab in inflammatory ocular neovascularization", Am J Ophthalmol, 148, pp.310.e2~316.e2 (2009)
- Chan WM., "Intravitreal bevacizumab(avastin)for choroidal neovascularization secondary to central serous chorioretinopathy, secondary to punctate inner choroidopathy, or of idiopathic origin", Am J Ophthalmol, 143, pp.977~983 (2007)
- Campos J., "Punctate inner choroidopathy : a clinical case report", Case Rep Ophthalmol, 28, pp.155~159 (2013)
- Gerstenblith AT., "Punctate inner choroidopathy : a survey analysis of 77 persons", Ophthalmology, 114, pp.1201~1204 (2007)
- Zhang H., "Intravitreal bevacizumab as primary treatment of choroidal neovascularization secondary to punctate inner choroidopathy : results of a 1-year prospective trial", Retina, 32, pp.1106~1113 (2012)
- Arevalo JF., "Intravitreal bevacizumab for inflammatory choroidal neovascularization : results from the Pan-American Collaborative Retina Study Group at 24 months", Retina, 31, pp.353~363 (2011)
- Schouten JS., "A systematic review on the effect of bevacizumab in exudative age-related macular degeneration", Graefes Arch Clin Exp Ophthalmol, 247, pp.1~11 (2009)
- Mansour AM., "Three-year visual and anatomic results of administrating intravitreal bevacizumab in inflammatory ocular neovascularization", Can J Ophthalmol, 47, pp.269~274 (2012)
- Mangat SS., "Resolution of choroidal neovascularization secondary to punctate inner choroidopathy(PIC)with intravitreal anti-VEGF agents : a case series", Semin Ophthalmol, 26, pp.1~3 (2011)
- Cornish KS., "Management of inflammatory choroidal neovascularization(CNV)secondary to punctate inner choroidopathy in a young female of childbearing age with intra-vitreal ranibizumab and half-fluence photodynamic therapy(PDT)-a holistic approach", Semin Ophthalmol, 27, pp.29~32 (2012)